Pernille Tine Jensen

Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up. / Jeppesen, Mette Moustgaard; Mogensen, Ole; Hansen, Dorte Gilså; Iachina, Maria; Korsholm, Malene; Jensen, Pernille Tine.

I: Acta oncologica (Stockholm, Sweden), Bind 56, Nr. 2, 02.2017, s. 262-269.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

Jeppesen, MM, Mogensen, O, Hansen, DG, Iachina, M, Korsholm, M & Jensen, PT 2017, 'Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up', Acta oncologica (Stockholm, Sweden), bind 56, nr. 2, s. 262-269. https://doi.org/10.1080/0284186X.2016.1267396

APA

Jeppesen, M. M., Mogensen, O., Hansen, D. G., Iachina, M., Korsholm, M., & Jensen, P. T. (2017). Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up. Acta oncologica (Stockholm, Sweden), 56(2), 262-269. https://doi.org/10.1080/0284186X.2016.1267396

CBE

MLA

Vancouver

Author

Jeppesen, Mette Moustgaard ; Mogensen, Ole ; Hansen, Dorte Gilså ; Iachina, Maria ; Korsholm, Malene ; Jensen, Pernille Tine. / Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up. I: Acta oncologica (Stockholm, Sweden). 2017 ; Bind 56, Nr. 2. s. 262-269.

Bibtex

@article{a667ebf7bb3e4c83a6cb073711ab7739,
title = "Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up",
abstract = "BACKGROUND: Considerable controversy remains as to the optimal organization of endometrial cancer follow-up.AIM: To evaluate the relationship between the way recurrence was detected and survival after treatment for endometrial cancer. Further, to identify characteristics associated with a pre-scheduled examination in women with symptomatic recurrence.MATERIAL AND METHODS: All women with early stage endometrial cancer during 2005-2009 were included in a population-based historical cohort derived from the Danish Gynecological Cancer Database. Women diagnosed with recurrence within three years after primary surgery and the mode of recurrence detection were identified from hospital charts: asymptomatic recurrence detected at regular follow-up, symptomatic recurrence detected at regular follow-up or symptomatic recurrence detected in between follow-up. Survival of women with symptomatic and asymptomatic disease was compared. Furthermore, characteristics associated with self-referral as compared to presenting symptoms at regular follow-ups were identified using univariate analyses.RESULTS: In total, 183 cases of recurrence (7%) were identified in the cohort of 2612 women. Of these, 65.5% were symptomatic with vaginal bleeding as the most prevalent symptom. Asymptomatic women had a significantly better three-year survival rate compared to symptomatic women (80.3% vs. 54.3%, p < 0.01). A total of 2.3% of the entire population had an asymptomatic recurrence. Women diagnosed at a pre-scheduled visit due to symptoms had a higher educational level (p = 0.03) and more often high-risk disease (p = 0.02) than symptomatic women diagnosed at regular follow-up.CONCLUSION: Early stage endometrial cancer carries a low risk of recurrence. Survival appears to be superior in asymptomatic patients, but length-time bias, i.e. the effect of aggressive tumor biology in symptomatic recurrences, may bias results in non-randomized controlled trials. Well educated patients with symptoms of recurrence more often sought medical attendance compared to less educated counterparts. This should be considered if patient-initiated follow-up is the standard care.",
keywords = "Aged, Endometrial Neoplasms/diagnosis, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Recurrence, Local/diagnosis, Neoplasm Staging",
author = "Jeppesen, {Mette Moustgaard} and Ole Mogensen and Hansen, {Dorte Gils{\aa}} and Maria Iachina and Malene Korsholm and Jensen, {Pernille Tine}",
year = "2017",
month = feb,
doi = "10.1080/0284186X.2016.1267396",
language = "English",
volume = "56",
pages = "262--269",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Taylor & Francis ",
number = "2",

}

RIS

TY - JOUR

T1 - Detection of recurrence in early stage endometrial cancer - the role of symptoms and routine follow-up

AU - Jeppesen, Mette Moustgaard

AU - Mogensen, Ole

AU - Hansen, Dorte Gilså

AU - Iachina, Maria

AU - Korsholm, Malene

AU - Jensen, Pernille Tine

PY - 2017/2

Y1 - 2017/2

N2 - BACKGROUND: Considerable controversy remains as to the optimal organization of endometrial cancer follow-up.AIM: To evaluate the relationship between the way recurrence was detected and survival after treatment for endometrial cancer. Further, to identify characteristics associated with a pre-scheduled examination in women with symptomatic recurrence.MATERIAL AND METHODS: All women with early stage endometrial cancer during 2005-2009 were included in a population-based historical cohort derived from the Danish Gynecological Cancer Database. Women diagnosed with recurrence within three years after primary surgery and the mode of recurrence detection were identified from hospital charts: asymptomatic recurrence detected at regular follow-up, symptomatic recurrence detected at regular follow-up or symptomatic recurrence detected in between follow-up. Survival of women with symptomatic and asymptomatic disease was compared. Furthermore, characteristics associated with self-referral as compared to presenting symptoms at regular follow-ups were identified using univariate analyses.RESULTS: In total, 183 cases of recurrence (7%) were identified in the cohort of 2612 women. Of these, 65.5% were symptomatic with vaginal bleeding as the most prevalent symptom. Asymptomatic women had a significantly better three-year survival rate compared to symptomatic women (80.3% vs. 54.3%, p < 0.01). A total of 2.3% of the entire population had an asymptomatic recurrence. Women diagnosed at a pre-scheduled visit due to symptoms had a higher educational level (p = 0.03) and more often high-risk disease (p = 0.02) than symptomatic women diagnosed at regular follow-up.CONCLUSION: Early stage endometrial cancer carries a low risk of recurrence. Survival appears to be superior in asymptomatic patients, but length-time bias, i.e. the effect of aggressive tumor biology in symptomatic recurrences, may bias results in non-randomized controlled trials. Well educated patients with symptoms of recurrence more often sought medical attendance compared to less educated counterparts. This should be considered if patient-initiated follow-up is the standard care.

AB - BACKGROUND: Considerable controversy remains as to the optimal organization of endometrial cancer follow-up.AIM: To evaluate the relationship between the way recurrence was detected and survival after treatment for endometrial cancer. Further, to identify characteristics associated with a pre-scheduled examination in women with symptomatic recurrence.MATERIAL AND METHODS: All women with early stage endometrial cancer during 2005-2009 were included in a population-based historical cohort derived from the Danish Gynecological Cancer Database. Women diagnosed with recurrence within three years after primary surgery and the mode of recurrence detection were identified from hospital charts: asymptomatic recurrence detected at regular follow-up, symptomatic recurrence detected at regular follow-up or symptomatic recurrence detected in between follow-up. Survival of women with symptomatic and asymptomatic disease was compared. Furthermore, characteristics associated with self-referral as compared to presenting symptoms at regular follow-ups were identified using univariate analyses.RESULTS: In total, 183 cases of recurrence (7%) were identified in the cohort of 2612 women. Of these, 65.5% were symptomatic with vaginal bleeding as the most prevalent symptom. Asymptomatic women had a significantly better three-year survival rate compared to symptomatic women (80.3% vs. 54.3%, p < 0.01). A total of 2.3% of the entire population had an asymptomatic recurrence. Women diagnosed at a pre-scheduled visit due to symptoms had a higher educational level (p = 0.03) and more often high-risk disease (p = 0.02) than symptomatic women diagnosed at regular follow-up.CONCLUSION: Early stage endometrial cancer carries a low risk of recurrence. Survival appears to be superior in asymptomatic patients, but length-time bias, i.e. the effect of aggressive tumor biology in symptomatic recurrences, may bias results in non-randomized controlled trials. Well educated patients with symptoms of recurrence more often sought medical attendance compared to less educated counterparts. This should be considered if patient-initiated follow-up is the standard care.

KW - Aged

KW - Endometrial Neoplasms/diagnosis

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Neoplasm Recurrence, Local/diagnosis

KW - Neoplasm Staging

U2 - 10.1080/0284186X.2016.1267396

DO - 10.1080/0284186X.2016.1267396

M3 - Journal article

C2 - 28080157

VL - 56

SP - 262

EP - 269

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 2

ER -